{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T00:00:58Z","timestamp":1793318458906,"version":"4.5.0"},"reference-count":114,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Heavy metals (HMs) were originally formed in the universe long before human evolution and are now ubiquitous in the environment, where some HMs are good as essential elements for human health while others are not. The purpose of this analytical review is to provide an updated clinical overview on health risks attributable to drinking water containing specific HMs and to discuss new aspects of molecular steps leading to disrupted diseases. This approach was favored because the study cohorts were homogeneous, since exposed individuals lived in households where all members had access to the same drinking water of constant quality. Among the HMs under consideration, aluminum, arsenic, cadmium, chromium, copper, iron, lead, manganese, and mercury were detected in drinking water and represented a health risk if levels were above thresholds recommended by national and international regulatory authorities. For example, (1) aluminum increased the risk of dementia and Alzheimer\u2019s disease; (2) arsenic was associated with the development of bladder cancer; (3) cadmium increased the no-carcinogenic, as well as the carcinogenic, health risk; (4) chromium was considered as a risk factor for liver and kidney injury, as well cancer development; (5) copper contributed to cognitive impairment in the aging population and Alzheimer\u2019s disease; (6) iron increased the non-carcinogenic health risk; (7) lead impaired neurodevelopmental functions in children; (8) manganese increased the risk of attention-deficit hyperactivity disorder (ADHD); and (9) mercury was causally related to chronic kidney disease. In contrast, for nickel and zinc, no overt health risks have been reported, likely due to low levels in the drinking water, attributable to their low water solubility. Of note is the good news that some HMs represent essential elements for human health. In essence, many HMs were detected in drinking water and exerted non-carcinogenic or carcinogenetic health risks, requiring proactive management of national and international regulatory authorities.<\/jats:p>","DOI":"10.3390\/ijms262311656","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T08:49:22Z","timestamp":1764665362000},"page":"11656","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Heavy Metals Like Aluminum, Arsenic, Cadmium, Chromium, Copper, Iron, Lead, Manganese, Mercury, Nickel, and Zinc Polluting the Drinking Water: Their Individual Health Hazards"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8910-1200","authenticated-orcid":false,"given":"Rolf","family":"Teschke","sequence":"first","affiliation":[{"name":"Department of Internal Medicine II, Division of Gastroenterology and Hepatology, Klinikum Hanau, 63450 Hanau, Germany"},{"name":"Academic Teaching Hospital of the Medical Faculty, Goethe University Frankfurt, 60629 Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7103-5698","authenticated-orcid":false,"given":"Tran Dang","family":"Xuan","sequence":"additional","affiliation":[{"name":"Center for the Planetary Health and Innovation Science, The IDEC Institute, Hiroshima University, Higashi-Hiroshima 739-8529, Japan"},{"name":"Graduate School of Advanced Science and Engineering, Hiroshima University, Higashi-Hiroshima 739-8529, Japan"},{"name":"Graduate School of Innovation and Practice for Smart Society, Hiroshima University, Higashi-Hiroshima 739-8529, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Jomova, K., Makova, M., Alomar, S.Y., Alwasel, S.H., Nepovimova, E., Kuca, K., Rhodes, C.J., and Valko, M. (2022). Essential metals in health and disease. Chem. Biol. Interact., 367.","DOI":"10.1016\/j.cbi.2022.110173"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Teschke, R. (2022). Aluminum, Arsenic, Beryllium, Cadmium, Chromium, Cobalt, Copper, Iron, Lead, Mercury, Molybdenum, Nickel, Platinum, Thallium, Titanium, Vanadium, and Zinc: Molecular aspects in experimental liver injury. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms232012213"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Teschke, R., and Xuan, T.D. (2022). Heavy metals, halogenated hydrocarbons, phthalates, glyphosate, cordycepin, alcohol, drugs, and herbs, assessed for liver injury and mechanistic steps. Special Issue: Hepatotoxicity: Molecular Mechanisms and Pathophysiology. Front. Biosci. Landmark, 27.","DOI":"10.31083\/j.fbl2711314"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Teschke, R. (2024). Copper, iron, cadmium, and arsenic, all generated in the universe: Elucidating their environmental impact risk on human health including clinical liver injury. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25126662"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Genchi, G., Lauria, G., Catalano, A., Carocci, A., and Sinicropi, M.S. (2023). Prevalence of cobalt in the environment and its role in biological processes. Biology, 12.","DOI":"10.3390\/biology12101335"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Binesh, A., and Venkatachalam, K. (2024). Copper in human health and disease: A comprehensive review. J. Biochem. Mol. Toxicol., 38.","DOI":"10.1002\/jbt.70052"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1093\/ndt\/gfae095","article-title":"Iron biology","volume":"39","author":"Girelli","year":"2024","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Obeng, S.K., Kulh\u00e1nek, M., Bal\u00edk, J., \u010cern\u00fd, J., and Sedl\u00e1\u0159, O. (2024). Manganese: From soil to human health\u2014A comprehensive overview of its biological and environmental significance. Nutrients, 16.","DOI":"10.3390\/nu16203455"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Adamus, J.P., Ruszczy\u0144ska, A., and Wycza\u0142kowska-Tomasik, A. (2024). Molybdenum\u2019s role as an essential element in enzymes catabolizing redox reactions: A review. Biomolecules, 14.","DOI":"10.3390\/biom14070869"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1007\/s10238-024-01302-6","article-title":"Role of zinc in health and disease","volume":"24","author":"Stiles","year":"2024","journal-title":"Clin. Exp. Med."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Teschke, R. (2024). Hemochromatosis: Ferroptosis, ROS, gut microbiome, and clinical challenges with alcohol as confounding variable. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25052668"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Teschke, R., and Eickhoff, A. (2024). Wilson disease: Copper-mediated cuproptosis, iron-related ferroptosis, and clinical highlights, with comprehensive and critical analysis update. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25094753"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1093\/aje\/152.1.59","article-title":"Relation between aluminum concentrations in drinking water and Alzheimer\u2019s disease: An 8-year follow-up study","volume":"152","author":"Rondeau","year":"2000","journal-title":"Am. J. Epidemiol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Krupi\u0144ska, I. (2020). Aluminium drinking water treatment residuals and their toxic impact on human health. Molecules, 25.","DOI":"10.3390\/molecules25030641"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Cutipa-D\u00edaz, Y.M., Huanacuni-Lupaca, C., Limache-Sandoval, E.M., Mamani-Huanca, D.Y., S\u00e1nchez-Esquiche, W.M., Rubira-Otarola, D.G., Guti\u00e9rrez-Cueva, R.N., and Sacari Sacari, E.J. (2024). Exposure to aluminum in drinking water and the risk of developing Alzheimer\u2019s disease: A bibliometric analysis and systematic evaluation. Water, 16.","DOI":"10.3390\/w16172386"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"104200","DOI":"10.1016\/j.rineng.2025.104200","article-title":"Human health risk assessment of aluminium in water treated with aluminium-based coagulants in a rural area","volume":"25","year":"2025","journal-title":"Results Eng."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/1476-069X-13-44","article-title":"Arsenic in drinking water and urinary tract cancers: A systematic review of 30 years of epidemiological evidence","volume":"13","author":"Parker","year":"2014","journal-title":"Environ. Health"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"139683","DOI":"10.1016\/j.scitotenv.2020.139683","article-title":"Reduction in drinkingwater arsenic exposure and health risk through arsenic treatment among private well households in Maine and New Jersey, USA","volume":"738","author":"Yang","year":"2020","journal-title":"Sci. Total Environ."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"159118","DOI":"10.1016\/j.scitotenv.2022.159118","article-title":"Assessment of cause-specific mortality and disability-adjusted life years (DALYs) induced by exposure to inorganic arsenic through drinking water and foodstuffs in Iran","volume":"856","author":"Abtahi","year":"2023","journal-title":"Sci. Total Environ."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Frisbie, S.H., and Mitchell, E.J. (2022). Arsenic in drinking water: An analysis of global drinking water regulations and recommenddations for updates to protect public health. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0263505"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Yadav, A.K., Shirin, S., Simon, M., Kumar, A., and Dikshit, A.K. (2025). Health impacts of arsenic exposure and regulations for safe drinking water. Arsenic Removal Technologies, Springer.","DOI":"10.1007\/978-3-031-91171-2"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Wu, F., van Geen, A., Graziano, J., Ahmed, K.M., Liu, M., Argos, M., Parvez, F., Choudhury, I., Slavkovich, V.N., and Ellis, T. (2025). Arsenic exposure reduction and chronic disease mortality. JAMA, e2519161.","DOI":"10.1001\/jama.2025.19161"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1007\/s12011-019-1660-7","article-title":"Cadmium in groundwater consumed in the rural areas of Gonabad and Bajestan, Iran: Occurrence and health risk assessment","volume":"192","author":"Qasemi","year":"2019","journal-title":"Biol. Trace Elem. Res."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Ahmed, M.F., and Mokhtar, M.B. (2020). Assessing Cadmium and chromium concentrations in drinking water to predict health risk in Malaysia. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17082966"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e2023020","DOI":"10.5620\/eaht.2023020","article-title":"Quality and risk assessment of lead and cadmium in drinking water for child development centres use in Phatthalung province, Thailand","volume":"38","author":"Decharat","year":"2023","journal-title":"Environ. Anal. Health Toxicol."},{"key":"ref_26","first-page":"132","article-title":"Cadmium toxicity in drinking water: A case study of Sialkot, risk assessment, cancer risks, and public health Implications","volume":"10","author":"Hameed","year":"2025","journal-title":"J. Environ. Soc. Sci."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Tumolo, M., Ancona, V., De Paola, D., Losacco, D., Campanale, C., Massarelli, C., and Uricchio, V.F. (2020). Chromium pollution in European water, sources, health risk, and remediation strategies: An overview. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17155438"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"835","DOI":"10.2166\/wh.2020.087","article-title":"Association between concentrations of chromium in drinking water and mortality due to suicide in Alabama","volume":"18","author":"Whitaker","year":"2020","journal-title":"J. Water Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"16458","DOI":"10.1007\/s11356-020-11649-4","article-title":"Health risk assessment of chromium contamination in the nearby population of mining plants, situated at Balochistan, Pakistan","volume":"28","author":"Chandio","year":"2021","journal-title":"Environ. Sci. Pollut. Res. Int."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Georgaki, M.N., Charalambous, M., Kazakis, N., Talias, M.A., Georgakis, C., Papamitsou, T., and Miyawaki, C. (2023). Chromium in water and carcinogenic human health risk. Environments, 10.","DOI":"10.3390\/environments10020033"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2356614","DOI":"10.1080\/17518253.2024.2356614","article-title":"Water contamination due to hexavalent chromium and its health impacts: Exploring green technology for Cr (VI) remediation","volume":"17","author":"Xie","year":"2024","journal-title":"Green Chem. Lett. Rev."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e158609","DOI":"10.5812\/healthscope-158609","article-title":"Assessment of human health risk from chromium in drinking water in the northeast of Iran using the Monte Carlo Simulation","volume":"14","author":"Paydar","year":"2025","journal-title":"Health Scope"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1098S","DOI":"10.1093\/ajcn\/67.5.1098S","article-title":"Safety guidelines for copper in water","volume":"67","author":"Fitzgerald","year":"1998","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_34","first-page":"219","article-title":"Chronic poisoning by copper in tap water: I. Copper intoxications with predominantly gastrointestinal symptoms","volume":"4","author":"Eife","year":"1999","journal-title":"Eur. J. Med. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.1289\/ehp.6913","article-title":"Community-based randomized double-blind study of gastrointestinal effects and copper exposure in drinking water","volume":"112","author":"Araya","year":"2004","journal-title":"Environ. Health Perspect."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1080\/07315724.2009.10719777","article-title":"The risks of copper toxicity contributing to cognitive decline in the aging population and to Alzheimer\u2019s disease","volume":"28","author":"Brewer","year":"2009","journal-title":"J. Am. Coll. Nutr."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"32184","DOI":"10.1039\/C9RA05880J","article-title":"The role of surface copper content on biofilm formation by drinking water bacteria","volume":"9","author":"Gomes","year":"2019","journal-title":"RSC Adv."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s13201-021-01542-x","article-title":"Water quality and risk assessment of copper content in drinking water stored in copper container","volume":"12","author":"Manne","year":"2022","journal-title":"Appl. Water Sci."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e1270","DOI":"10.1002\/aws2.1270","article-title":"School and childcare center drinking water: Copper chemistry, health effects, occurrence, and remediation","volume":"4","author":"Montagnino","year":"2022","journal-title":"AWWA Water Sci."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Ghosh, G.C., Khan, M.J.H., Chakraborty, T.K., Zaman, S., Kabir, A.H.M.E., and Tanaka, H. (2020). Human health risk assessment of elevated and variable iron and manganese intake with arsenic-safe groundwater in Jashore, Bangladesh. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-62187-5"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1007\/s12517-021-06450-7","article-title":"Iron in groundwater: Quality evaluation, health risk, and spatial distribution in Rangpur City Corporation","volume":"14","author":"Haque","year":"2021","journal-title":"Arab. J. Geosci."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"103690","DOI":"10.1016\/j.etap.2021.103690","article-title":"Evaluating the geochemistry of groundwater contamination with iron and manganese and probabilistic human health risk assessment in endemic areas of the world\u2019s largest River Island, India","volume":"87","author":"Sharma","year":"2021","journal-title":"Environ. Toxicol. Pharmacol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1007\/s10653-024-02307-6","article-title":"The coupling effect and ecological risk assessment of iron, manganese, and arsenic in the water environment of the central Yangtze River Basin, China","volume":"47","author":"Hu","year":"2024","journal-title":"Environ. Geochem. Health"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"58","DOI":"10.3329\/bafmj.v56i2.73013","article-title":"Iron in drinking water and its impact on human health\u2014A study in selected units of Jalalabad cantonment","volume":"56","author":"Rahman","year":"2024","journal-title":"Bangladesh Armed Forces Med. J."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"S73","DOI":"10.1016\/S0278-6915(99)00137-4","article-title":"Public health implications of new guidelines for lead in drinking water: A case study in an area with historically high water lead levels","volume":"38","author":"Watt","year":"2000","journal-title":"Food Chem. Toxicol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1503\/cmaj.071483","article-title":"Lead in drinking water","volume":"179","author":"Payne","year":"2008","journal-title":"Can. Med Assoc. J."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"283","DOI":"10.2105\/AJPH.2015.303003","article-title":"Elevated blood lead levels in children associated with the Flint Drinking Water Crisis: A spatial analysis of risk and public health response","volume":"106","author":"LaChance","year":"2016","journal-title":"Am. J. Public Health"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/j.scitotenv.2017.02.164","article-title":"A discussion about public health, lead and Legionella pneumophila in drinking water supplies in the United States","volume":"590\u2013591","author":"Rosen","year":"2017","journal-title":"Sci. Total Environ."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1007\/s40572-018-0193-0","article-title":"Public health consequences of lead in drinking water","volume":"5","author":"Levallois","year":"2018","journal-title":"Curr. Environ. Health Rep."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Fawkes, L., and Sansom, G. (2021). Preliminary Study of lead-contaminated drinking water in public parks\u2014An assessment of equity and exposure risks in two Texas communities. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18126443"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"100239","DOI":"10.1016\/j.coesh.2021.100239","article-title":"Lead in drinking water\u2014An ongoing public health concern?","volume":"20","author":"Jarvis","year":"2021","journal-title":"Curr. Opin. Environ. Sci. Health"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Bauza, V., Furey, S., Alvarez Sala, J., Bartram, J., Danert, K., France, J., Diarra, S., Fisher, M., Hansen, D., and Hutchings, P. (2023). Eliminating lead exposure from drinking water\u2014A global call to action. PLOS Water, 2.","DOI":"10.1371\/journal.pwat.0000122"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1093\/toxsci\/kfad054","article-title":"Refining risk estimates for lead in drinking water based on the impact of genetics and diet on blood lead levels using the Collaborative Cross mouse population","volume":"194","author":"Cuomo","year":"2023","journal-title":"Toxicol. Sci."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1289\/ehp.10051","article-title":"Association between manganese exposure through drinking water and infant mortality in Bangladesh","volume":"115","author":"Hafeman","year":"2007","journal-title":"Environ. Health Perspect."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1533","DOI":"10.1289\/ehp.10316","article-title":"Time to re-evaluate the guideline value for manganese in drinking water?","volume":"115","author":"Ljung","year":"2007","journal-title":"Environ. Health Perspect."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.neuro.2019.02.013","article-title":"The effects of manganese exposure from drinking water on school-age children: A systematic review","volume":"73","author":"Iyare","year":"2019","journal-title":"Neurotoxicology"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"104889","DOI":"10.1016\/j.envint.2019.05.083","article-title":"A benchmark concentration analysis for manganese in drinking water and IQ deficits in children","volume":"130","author":"Kullar","year":"2019","journal-title":"Environ. Int."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"G\u00f3mez-Oliv\u00e1n, L. (2019). Impacts caused by manganese in the aquatic environments of Brazil. Pollution of Water Bodies in Latin America, Springer.","DOI":"10.1007\/978-3-030-27296-8"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"97004","DOI":"10.1289\/EHP6391","article-title":"Exposure to manganese in drinking water during childhood and association with attention-deficit hyperactivity disorder: A nationwide cohort study","volume":"128","author":"Schullehner","year":"2020","journal-title":"Environ. Health Perspect."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"45663","DOI":"10.1007\/s11356-021-14016-z","article-title":"Manganese in potable water of nine districts, Bangladesh: Human health risk","volume":"28","author":"Rahman","year":"2021","journal-title":"Environ. Sci. Pollut. Res. Int."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Kumar, A., Kumar, R., Kumar, G., Kumar, K., Chayal, N.K., Aryal, S., Kumar, M., Srivastava, A., Ali, M., and Raj, V. (2024). Manganese pollution in eastern India causing cancer risk. Sci. Rep., 14.","DOI":"10.1038\/s41598-024-78478-0"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Browning, E.G., Bartram, J.K., Guo, A.Z., Tracy, J.W., Kelly, E.R., Fisher, M.B., and Seidu, Z. (2025). Manganese and iron in drinking water in three West-African countries: Implications for health, acceptability, and disinfection. PLoS Water, 4.","DOI":"10.1371\/journal.pwat.0000234"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1704","DOI":"10.2166\/wpt.2025.107","article-title":"Manganese occurrence in groundwater and health risk assessment: A case study in various Upazillas of Chattogram district of Bangladesh","volume":"20","author":"Rahman","year":"2025","journal-title":"Water Pract. Technol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1007\/s13201-021-01551-w","article-title":"Domestic water and accumulating mercury toxicity in the kidney","volume":"12","author":"Abdeldayem","year":"2022","journal-title":"Appl. Water Sci."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41370-024-00639-0","article-title":"Assessing exposure and health consequences of chemicals in drinking water in the 21st Century","volume":"34","author":"Deziel","year":"2024","journal-title":"J. Expo. Sci. Environ. Epidemiol."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Kumar, N. (2024). A Review of mercury contamination in water and its impact on public health. Mercury Toxicity Mitigation: Sustainable Nexus Approach, Springer. Earth and Environmental Sciences Library.","DOI":"10.1007\/978-3-031-48817-7"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Charkiewicz, A.E., Omeljaniuk, W.J., Garley, M., and Nikli\u0144ski, J. (2025). Mercury exposure and health effects: What do we really know?. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26052326"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"3371","DOI":"10.1039\/D5MA00208G","article-title":"Mercury in aquatic environments: Toxicity and advances in remediation using covalent organic frameworks","volume":"6","author":"Kayani","year":"2025","journal-title":"Mater. Adv."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"117592","DOI":"10.1016\/j.marpolbul.2025.117592","article-title":"Mercury levels in freshwater aquatic products across China: Spatial distribution, species differences, and health risk assessment","volume":"212","author":"Xu","year":"2025","journal-title":"Mar. Pollut. Bull."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Payment, P. (2003). Health effects of water consumption and water quality. Handbook of Water and Wastewater Microbiology, Academic Press.","DOI":"10.1016\/B978-012470100-7\/50014-5"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1071\/NB97043","article-title":"Environmental health risk assessment of nickel contamination of drinking water in a country town in NSW","volume":"19","author":"Alam","year":"2008","journal-title":"N. S. Wales Public Health Bull."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1006\/rtph.2000.1378","article-title":"Hazard identification and dose response of ingested nickel-soluble salts","volume":"31","author":"Haber","year":"2000","journal-title":"Regul. Toxicol. Pharmacol."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Genchi, G., Carocci, A., Lauria, G., Sinicropi, M.S., and Catalano, A. (2020). Nickel: Human health and environmental toxicology. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17030679"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"111373","DOI":"10.1016\/j.ecoenv.2020.111373","article-title":"Acute and chronic toxicity of nickel on freshwater and marine tropical aquatic organisms","volume":"206","author":"Wang","year":"2020","journal-title":"Ecotoxicol. Environ. Saf."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"12531","DOI":"10.1007\/s11356-021-15137-1","article-title":"Widespread nickel contamination in drinking water supplies of elementary schools in Taichung, Taiwan","volume":"29","author":"Adhikari","year":"2022","journal-title":"Environ. Sci. Pollut. Res. Int."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1604","DOI":"10.1002\/etc.5352","article-title":"Assessing the extent of environmental risks from nickel in European freshwaters: A critical reflection of the European Commission\u2019s current approach","volume":"41","author":"Peters","year":"2022","journal-title":"Environ. Toxicol. Chem."},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Salehi, F., Esmaeilbeigi, M., Kazemi, A., Sharafi, S., Sahebi, Z., and Asl, A.G. (2024). Spatial health risk assessments of nickel in the groundwater sources of a mining-impacted area. Sci. Rep., 14.","DOI":"10.1038\/s41598-024-61914-6"},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Awasthi, K.K., Srivastava, S., and Rathore, S. (2025). Assessing the impact of nickel contamination in water on human health and the environment. The Green Revolution: Building Sustainable Solutions (RTESD 2023), Springer. Springer Proceedings in Earth and Environmental Sciences.","DOI":"10.1007\/978-3-031-93444-5"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.3390\/ijerph7041342","article-title":"The essential toxin: Impact of zinc on human health","volume":"7","author":"Plum","year":"2010","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"14364","DOI":"10.3390\/ijerph121114364","article-title":"Different choices of drinking water source and different health risks in a rural population living near a lead\/zinc mine in Shenzhou City, Southern China","volume":"12","author":"Huang","year":"2015","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_81","first-page":"447","article-title":"Essential, non-essential metals and human health","volume":"3","author":"Saad","year":"2016","journal-title":"Blue Biotech. J."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1480553","DOI":"10.1155\/2022\/1480553","article-title":"Aluminum poisoning with emphasis on its mechanism and treatment of intoxication","volume":"2022","author":"Rahimzadeh","year":"2022","journal-title":"Emerg. Med. Int."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"tfad111","DOI":"10.1093\/toxres\/tfad111","article-title":"Arsenic toxicity: Sources, pathophysiology and mechanism","volume":"13","author":"Ganie","year":"2023","journal-title":"Toxicol. Res."},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Qu, F., and Zheng, W. (2024). Cadmium exposure: Mechanisms and pathways of toxicity and implications for human health. Toxics, 12.","DOI":"10.3390\/toxics12060388"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.cotox.2019.05.003","article-title":"Mechanisms of chromium-induced toxicity","volume":"14","author":"DesMarais","year":"2019","journal-title":"Curr. Opin. Toxicol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1007\/s00424-020-02412-2","article-title":"The molecular mechanisms of copper metabolism and its roles in human diseases","volume":"472","author":"Chen","year":"2020","journal-title":"Pflugers Arch."},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"Kontoghiorghes, G.J. (2023). Iron load toxicity in medicine: From molecular and cellular aspects to clinical implications. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms241612928"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1007\/s12291-019-00829-w","article-title":"Novel direction in mechanisms underlying lead toxicity: Evidence and prospective","volume":"34","author":"Mitra","year":"2019","journal-title":"Indian J. Clin. Biochem."},{"key":"ref_89","first-page":"199","article-title":"Manganese in health and disease","volume":"13","author":"Avila","year":"2013","journal-title":"Met. Ions Hum. Dis."},{"key":"ref_90","first-page":"0033","article-title":"Perspective on Minamata disease: Epidemiology, clinical manifestations, diagnosis, and management","volume":"9","author":"Rukhsan","year":"2024","journal-title":"J. Clin. Med. Case Stud."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"5100","DOI":"10.1021\/acsomega.3c07047","article-title":"The toxicity of mercury and its chemical compounds: Molecular mechanisms and environmental and human health implications: A comprehensive review","volume":"9","author":"Wu","year":"2024","journal-title":"ACS Omega"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"345","DOI":"10.3109\/01480549709003892","article-title":"Gastrointestinal absorption of metals","volume":"20","author":"Diamond","year":"1997","journal-title":"Drug Chem. Toxicol."},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Bolan, S., Seshadri, B., Keely, S., Kunhikrishnan, A., Bruce, J., Grainge, I., Talley, N.J., and Naidu, R. (2021). Bioavailability of arsenic, cadmium, lead and mercury as measured by intestinal permeability. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-94174-9"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"5328","DOI":"10.1007\/s12011-021-03092-4","article-title":"Impact of heavy metal toxicity on the gut microbiota and its relationship with metabolites and future probiotics strategy: A review","volume":"200","author":"Bist","year":"2022","journal-title":"Biol. Trace Elem. Res."},{"key":"ref_95","doi-asserted-by":"crossref","unstructured":"Zhu, Q., Chen, B., Zhang, F., Zhang, B., Guo, Y., Pang, M., Huang, L., and Wang, T. (2024). Toxic and essential metals: Metabolic interactions with the gut microbiota and health implications. Front. Nutr., 11.","DOI":"10.3389\/fnut.2024.1448388"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/s00204-024-03903-2","article-title":"Heavy metals: Toxicity and human health effects","volume":"99","author":"Jomova","year":"2024","journal-title":"Arch. Toxicol."},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Wang, X., Han, X., Guo, S., Ma, Y., and Zhang, Y. (2024). Associations between patterns of blood heavy metal exposure and health outcomes: Insights from NHANES 2011\u20132016. BMC Public Health, 24.","DOI":"10.1186\/s12889-024-17754-0"},{"key":"ref_98","doi-asserted-by":"crossref","unstructured":"Balali-Mood, M., Naseri, K., Tahergorabi, Z., Khazdair, M.R., and Sadeghi, M. (2021). toxic mechanisms of five heavy metals: Mercury, lead, chromium, cadmium, and arsenic. Front. Pharmacol., 12.","DOI":"10.3389\/fphar.2021.643972"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1080\/17435390.2017.1293750","article-title":"Reactive oxygen species generation by copper(II) oxide nanoparticles determined by DNA damage assays and EPR spectroscopy","volume":"11","author":"Nguyen","year":"2017","journal-title":"Nanotoxicology"},{"key":"ref_100","doi-asserted-by":"crossref","unstructured":"Quan, N.V., Dang Xuan, T., and Teschke, R. (2020). Potential hepatotoxins found in herbal medicinal products: A systematic review. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21145011"},{"key":"ref_101","doi-asserted-by":"crossref","unstructured":"Karousatos, C.M., Lee, J.K., Braxton, D.R., and Fong, T.L. (2021). Case series and review of Ayurvedic medication induced liver injury. BMC Complement. Med. Ther., 21.","DOI":"10.1186\/s12906-021-03251-z"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/S1665-2681(19)31777-6","article-title":"Severe hepatotoxicity by Indian Ayurvedic herbal products: A structured causality assessment","volume":"8","author":"Teschke","year":"2009","journal-title":"Ann. Hepatol."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1007\/s12664-017-0815-8","article-title":"Clinical outcomes, histopathological patterns, and chemical analysis of Ayurveda and herbal medicine associated with severe liver injury-A single-center experience from southern India","volume":"37","author":"Philips","year":"2018","journal-title":"Indian J. Gastroenterol."},{"key":"ref_104","doi-asserted-by":"crossref","unstructured":"Danan, G., and Teschke, R. (2016). RUCAM in drug and herb induced liver injury: The update. Int. J. Mol. Sci., 17.","DOI":"10.3390\/ijms17010014"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1016\/0895-4356(93)90101-6","article-title":"Causality assessment of adverse reactions to drugs\u2014I. A novel method based on the conclusions of international consensus meetings: Application to drug-induced liver injuries","volume":"46","author":"Danan","year":"1993","journal-title":"J. Clin. Epidemiol."},{"key":"ref_106","doi-asserted-by":"crossref","unstructured":"Vongdala, N., Tran, H.D., Xuan, T.D., Teschke, R., and Khanh, T.D. (2019). Heavy metal accumulation in water, soil, and plants of municipal solid waste landfill in Vientiane, Laos. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16010022"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3109\/10408449509089885","article-title":"Minamata disease: Methylmercury poisoning in Japan caused by environmental pollution","volume":"25","author":"Harada","year":"1995","journal-title":"Crit. Rev. Toxicol."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1265\/jjh.72.140","article-title":"Effects of Prenatal methylmercury exposure: From Minamata disease to environmental health studies","volume":"72","author":"Sakamoto","year":"2017","journal-title":"Nihon Eiseigaku Zasshi"},{"key":"ref_109","first-page":"100485","article-title":"Inhalational exposure to heavy metals: Carcinogenic and non-carcinogenic risk assessment","volume":"16","author":"Khoshakhlagh","year":"2024","journal-title":"J. Hazard. Mater. Adv."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1007\/s12011-014-9984-9","article-title":"The influence of the occupational exposure to heavy metals and tobacco smoke on the selected oxidative stress markers in smelters","volume":"159","author":"Zalewska","year":"2014","journal-title":"Biol. Trace Elem. Res."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1177\/07482337241247088","article-title":"Health risk assessment of occupational exposure to heavy metals among green space workers in Iran","volume":"40","author":"Abbaslou","year":"2024","journal-title":"Toxicol. Ind. Health"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"e08914","DOI":"10.1016\/j.heliyon.2022.e08914","article-title":"Investigation of dermal exposure to heavy metals (Cu, Zn, Ni, Al, Fe and Pb) in traditional batik industry workers","volume":"8","author":"Oginawati","year":"2022","journal-title":"Heliyon"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"172556","DOI":"10.1016\/j.scitotenv.2024.172556","article-title":"To breathe or not to breathe: Inhalational exposure to heavy metals and related health risk","volume":"932","author":"Khoshakhlagh","year":"2024","journal-title":"Sci. Total Environ."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"141474","DOI":"10.1016\/j.chemosphere.2024.141474","article-title":"Artificial intelligence and machine learning algorithms in the detection of heavy metals in water and wastewater: Methodological and ethical challenges","volume":"353","author":"Maurya","year":"2024","journal-title":"Chemosphere"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/23\/11656\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T08:52:14Z","timestamp":1764665534000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/23\/11656"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,1]]},"references-count":114,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["ijms262311656"],"URL":"https:\/\/doi.org\/10.3390\/ijms262311656","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,1]]}}}